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Gately L, Mesía C, Sepúlveda JM, Del Barco S, Pineda E, Gironés R, Fuster J, Hong W, Dumas M, Gill S, Navarro LM, Herrero A, Dowling A, de Las Peñas R, Vaz MA, Alonso M, Lwin Z, Harrup R, Peralta S, Long A, Perez-Segura P, Ahern E, Garate CO, Wong M, Campbell R, Cuff K, Jennens R, Gallego O, Underhill C, Martinez-Garcia M, Covela M, Cooper A, Brown S, Rosenthal M, Torres J, Collins IM, Gibbs P, Balana C. Correction to: A combined analysis of two prospective randomised studies exploring the impact of extended post-radiation temozolomide on survival outcomes in newly diagnosed glioblastoma. J Neurooncol 2024; 166:417-418. [PMID: 38289531 DOI: 10.1007/s11060-024-04581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- L Gately
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia.
| | - C Mesía
- Medical Oncology Service, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - J M Sepúlveda
- Medical Oncology Service, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia Girona, Girona, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic de Barcelona, Barcelona, Spain
| | - R Gironés
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J Fuster
- Medical Oncology Service, Hospital Son Espases, Palma de Mallorca, Spain
| | - W Hong
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - M Dumas
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - S Gill
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia
| | - L M Navarro
- Medical Oncology Service, Hospital de Salamanca, Salamanca, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Zaragoza, Spain
| | - A Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - R de Las Peñas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - M A Vaz
- Medical Oncology Service, Hospital Ramón y Cajal, Madrid, Spain
| | - M Alonso
- Medical Oncology Service, Hospital Virgen del Rocio, Seville, Spain
| | - Z Lwin
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - R Harrup
- Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - S Peralta
- Medical Oncology Service, Hospital Sant Joan de Reus, Reus, Spain
| | - A Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - P Perez-Segura
- Medical Oncology Service, Hospital Clinico San Carlos, Madrid, Spain
| | - E Ahern
- Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
| | - C O Garate
- Medical Oncology Service, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - M Wong
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - R Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - K Cuff
- Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, Richmond, VIC, Australia
| | - O Gallego
- Medical Oncology Service, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - C Underhill
- Department of Medical Oncology, Border Medical Oncology, East Albury, NSW, Australia
| | | | - M Covela
- Medical Oncology Service, Hospital Lucus Augusti, Lugo, Spain
| | - A Cooper
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - S Brown
- Department of Medical Oncology, Ballarat Health Services, Ballarat, VIC, Australia
| | - M Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Torres
- Department of Medical Oncology, Goulburn Valley Health, Shepparton, VIC, Australia
| | - I M Collins
- Department of Medical Oncology, South West Regional Cancer Centre, Geelong, VIC, Australia
| | - P Gibbs
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - C Balana
- Medical Oncology Service, Institut Català d'Oncologia, Badalona, Spain
- Badalona Applied Research Group in Oncology (B-ARGO), Institut Investigació Germans Trias I Pujol (IGTP), Badalona, Spain
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Gately L, Mesía C, Sepúlveda JM, Del Barco S, Pineda E, Gironés R, Fuster J, Hong W, Dumas M, Gill S, Navarro LM, Herrero A, Dowling A, de Las Peñas R, Vaz MA, Alonso M, Lwin Z, Harrup R, Peralta S, Long A, Perez-Segura P, Ahern E, Garate CO, Wong M, Campbell R, Cuff K, Jennens R, Gallego O, Underhill C, Martinez-Garcia M, Covela M, Cooper A, Brown S, Rosenthal M, Torres J, Collins IM, Gibbs P, Balana C. A combined analysis of two prospective randomised studies exploring the impact of extended post-radiation temozolomide on survival outcomes in newly diagnosed glioblastoma. J Neurooncol 2024; 166:407-415. [PMID: 38153582 DOI: 10.1007/s11060-023-04513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/15/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE The optimal duration of post-radiation temozolomide in newly diagnosed glioblastoma remains unclear, with no published phase III randomised trials. Standard-of-care stipulates 6 months. However, in routine care, it is often extended to 12 months, despite lacking robust supporting data. METHODS GEINO14-01 (Spain) and EX-TEM (Australia) studies enrolled glioblastoma patients without progression at the end of 6 months post-radiation temozolomide. Participants were randomised 1:1 to six additional months of temozolomide or observation. Primary endpoint was 6-month progression free survival from date of randomisation (6mPFS). Secondary endpoints included overall survival (OS) and toxicity. 204 patients were required to detect an improvement in 6mPFS from 50 to 60% (80% power). Neither study recruited sufficient patients. We performed a combined analysis of individual patient data. RESULTS 205 patients were recruited: 159 in GEINO14-01 (2014-2018) and 46 in EX-TEM (2019-2022). Median follow-up was 20.0 and 14.5 months. Baseline characteristics were balanced. There was no significant improvement in 6mPFS (57.2% vs 64.0%, OR0.75, p = 0.4), nor across any subgroups, including MGMT methylated; PFS (HR0.92, p = 0.59, median 7.8 vs 9.7 months); or OS (HR1.03, p = 0.87, median 20.1 vs 19.4 months). During treatment extension, 64% experienced any grade adverse event, mainly fatigue and gastrointestinal (both 54%). Only a minority required treatment changes: 4.5% dose delay, 7.5% dose reduction, 1.5% temozolomide discontinuation. CONCLUSION For glioblastoma patients, extending post-radiation temozolomide from 6 to 12 months is well tolerated but does not improve 6mPFS. We could not identify any subset that benefitted from extended treatment. Six months should remain standard-of-care.
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Affiliation(s)
- L Gately
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia.
| | - C Mesía
- Medical Oncology Service, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - J M Sepúlveda
- Medical Oncology Service, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia Girona, Girona, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic de Barcelona, Barcelona, Spain
| | - R Gironés
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J Fuster
- Medical Oncology Service, Hospital Son Espases, Palma de Mallorca, Spain
| | - W Hong
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - M Dumas
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - S Gill
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia
| | - L M Navarro
- Medical Oncology Service, Hospital de Salamanca, Salamanca, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Zaragoza, Spain
| | - A Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - R de Las Peñas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - M A Vaz
- Medical Oncology Service, Hospital Ramón y Cajal, Madrid, Spain
| | - M Alonso
- Medical Oncology Service, Hospital Virgen del Rocio, Seville, Spain
| | - Z Lwin
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - R Harrup
- Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - S Peralta
- Medical Oncology Service, Hospital Sant Joan de Reus, Reus, Spain
| | - A Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - P Perez-Segura
- Medical Oncology Service, Hospital Clinico San Carlos, Madrid, Spain
| | - E Ahern
- Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
| | - C O Garate
- Medical Oncology Service, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - M Wong
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - R Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - K Cuff
- Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, Richmond, VIC, Australia
| | - O Gallego
- Medical Oncology Service, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - C Underhill
- Department of Medical Oncology, Border Medical Oncology, East Albury, NSW, Australia
| | | | - M Covela
- Medical Oncology Service, Hospital Lucus Augusti, Lugo, Spain
| | - A Cooper
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - S Brown
- Department of Medical Oncology, Ballarat Health Services, Ballarat, VIC, Australia
| | - M Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Torres
- Department of Medical Oncology, Goulburn Valley Health, Shepparton, VIC, Australia
| | - I M Collins
- Department of Medical Oncology, South West Regional Cancer Centre, Geelong, VIC, Australia
| | - P Gibbs
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - C Balana
- Medical Oncology Service, Institut Català d'Oncologia, Badalona, Spain
- Badalona Applied Research Group in Oncology (B-ARGO), Institut Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
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Aparicio J, García Del Muro X, Maroto P, Terrasa J, Castellano D, Bastús R, Gumà J, Sagastibeltza N, Durán I, Ochenduszko S, Meana JA, García-Sánchez J, Arranz JA, Gironés R, Germà JR. Patterns of relapse and treatment outcome after active surveillance or adjuvant carboplatin for stage I seminoma: a retrospective study of the Spanish Germ Cell Cancer Group. Clin Transl Oncol 2020; 23:58-64. [PMID: 32462393 DOI: 10.1007/s12094-020-02393-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Active surveillance (AS) and adjuvant chemotherapy (AC) with carboplatin are valid alternatives for managing stage I seminoma, and most relapses can be cured with cisplatin-based chemotherapy. However, some reports suggest that AC may modify the classical pattern of recurrences. METHODS We analyzed all relapses observed in a series of 879 patients with stage I seminoma included in 4 consecutive studies of the Spanish Germ Cell Cancer Group. After a median follow-up of 67 months, recurrences were detected in 56/467 (12%) low-risk cases on AS and 13/412 (3%) high-risk cases after AC (p < 0.001). The objective was to describe clinical features, treatment and outcome. Univariate comparisons were performed between both groups. RESULTS No significant differences were found between relapses on AS and those after AC in terms of time to relapse (13 vs 17 months), size (26 vs 27 mm), location (retroperitoneum in 88% vs 85%), and method of detection (computed tomography in 77% vs 69%). Treatment consisted of chemotherapy (etoposide + cisplatin ± bleomycin) in 89% and 92%, respectively. Late relapses (after > 3 years) were seen in 11% vs 7.7% (p = NS) and second or successive recurrences in 1.8 vs 23% (p < 0.05). With a median follow-up of 130 moths, two patients died of seminoma-unrelated causes (AS group) and the rest are alive and disease-free. CONCLUSION In the setting of a risk-adapted treatment of stage I seminoma, the administration of two courses of AC in patients with tumor size > 4 cm and/or rete testis invasion is associated with a higher incidence of second recurrences but does not significantly modify the pattern of relapses or their outcome.
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Affiliation(s)
- J Aparicio
- Servicio de Oncología Médica, Hospital Universitario y Politécnico La Fe, Avda. Abril Martorell 106, 46026, Valencia, Spain.
| | - X García Del Muro
- Institut Catalá d'Oncologia Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain
| | - P Maroto
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Terrasa
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - D Castellano
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - R Bastús
- Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - J Gumà
- Hospital Universitari Sant Joan, URV, IISPV, Reus, Spain
| | | | - I Durán
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - S Ochenduszko
- Hospital Universitario Doctor Peset, Valencia, Spain
| | - J A Meana
- Hospital General Universitario, Alicante, Spain
| | | | - J A Arranz
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - R Gironés
- Servicio de Oncología Médica, Hospital Universitario y Politécnico La Fe, Avda. Abril Martorell 106, 46026, Valencia, Spain
| | - J R Germà
- Institut Catalá d'Oncologia Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain
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Feliu J, Heredia-Soto V, Gironés R, Jiménez-Munarriz B, Saldaña J, Guillén-Ponce C, Molina-Garrido MJ. Management of the toxicity of chemotherapy and targeted therapies in elderly cancer patients. Clin Transl Oncol 2019; 22:457-467. [PMID: 31240462 DOI: 10.1007/s12094-019-02167-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/16/2019] [Indexed: 12/22/2022]
Abstract
The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, so cancer treatment in the older patient remains a therapeutic challenge. The physiological changes associated with aging increase the risk of developing a serious toxicity induced by chemotherapy treatment, as well as other undesirable consequences as hospitalizations, dependence and non-compliance with treatment, that can negatively affect survival, quality of life and treatment efficacy. The use of hematopoietic growth factors and other active supportive interventions in the elderly can help prevent and/or alleviate these toxicities. However, we have little data on the efficacy and tolerance of support treatments in the older patient. The objective of this work is to review the most frequent toxicities of oncological treatments in the elderly and their management.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - V Heredia-Soto
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - R Gironés
- Medical Oncology Department, H. Lluís Alcanyís. Xàtiva, Valencia, Spain
| | - B Jiménez-Munarriz
- Medical Oncology Department, H. Universitario Clara Campal, Madrid, Spain
| | - J Saldaña
- Medical Oncology Department, Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, H. Universitario Ramón Y Cajal, Madrid, Spain
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Garde-Noguera J, Martin-Martorell P, De Julián M, Perez-Altozano J, Salvador-Coloma C, García-Sanchez J, Insa-Molla A, Martín M, Mielgo-Rubio X, Marin-Liebana S, Blasco-Cordellat A, Blasco-Molla S, Gironés R, Marquez-Medina D, Aparisi F, Cerda MCB, Macia-Escalante S, Sánchez A, Juan-Vidal O. Correction to: Predictive and prognostic clinical and pathological factors of nivolumab efficacy in non-small-cell lung cancer patients. Clin Transl Oncol 2018; 20:1096. [PMID: 29987667 DOI: 10.1007/s12094-018-1916-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Clinical and Translational Oncology.
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Affiliation(s)
- J Garde-Noguera
- Hospital Arnau de Vilanova, C/Sant Climent, 12, 46015, Valencia, Spain.
| | | | - M De Julián
- Hospital Provincial de Castellón, Castellón, Spain
| | | | | | - J García-Sanchez
- Hospital Arnau de Vilanova, C/Sant Climent, 12, 46015, Valencia, Spain
| | - A Insa-Molla
- University Hospital Clínic de Valencia, Valencia, Spain
| | - M Martín
- Hospital Dr Peset, Valencia, Spain
| | - X Mielgo-Rubio
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | | | | | | | - R Gironés
- Hospital Lluis Alcanyís, Xátiva, Spain
| | | | - F Aparisi
- Hospital Virgen de los Lirios, Alcoy, Spain
| | - M C Bas Cerda
- Universidad Politecnica de Valencia, Valencia, Spain
| | | | - A Sánchez
- Hospital Provincial de Castellón, Castellón, Spain
| | - O Juan-Vidal
- Hospital Universitari I Politècnic La Fe, Valencia, Spain
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Soto-Perez-de-Celis E, Cordoba R, Gironés R, Karnakis T, Paredero I, Chavarri-Guerra Y, Navarrete-Reyes AP, Avila-Funes JA. Cancer and aging in Ibero-America. Clin Transl Oncol 2018; 20:1117-1126. [DOI: 10.1007/s12094-018-1844-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/05/2018] [Indexed: 11/29/2022]
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Gironés R, Morilla I, Guillen-Ponce C, Torregrosa MD, Paredero I, Bustamante E, Del Barco S, Soler G, Losada B, Visa L, Llabrés E, Fox B, Firvida JL, Blanco R, Antonio M, Aparisi F, Pi-Figueras M, Gonzalez-Flores E, Molina-Garrido MJ, Saldaña J. Geriatric oncology in Spain: survey results and analysis of the current situation. Clin Transl Oncol 2017; 20:1087-1092. [PMID: 29327240 PMCID: PMC6061214 DOI: 10.1007/s12094-017-1813-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/16/2017] [Indexed: 11/30/2022]
Abstract
Introduction Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. Objectives The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. Methods A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Results Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. Conclusions From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.
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Affiliation(s)
- R Gironés
- Medical Oncology Unit. Hospital Lluís Alcanyís, Crta Xàtiva A Silla Km 2, Xàtiva, 46800, Valencia, Spain.
| | - I Morilla
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | | | | | - I Paredero
- Hospital Universitario Dr Peset, Valencia, Spain
| | - E Bustamante
- Althaia, Xarxa Assistencial I Universitaria Manresa, Barcelona, Spain
| | - S Del Barco
- Hospital Universitari Dr. Josep Trueta. ICO Girona, Girona, Spain
| | - G Soler
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - B Losada
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - L Visa
- Hospital Del Mar, Barcelona, Spain
| | - E Llabrés
- Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | - B Fox
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J L Firvida
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - R Blanco
- Consorci Sanitari de Terrassa, Barcelona, Spain
| | - M Antonio
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
| | - F Aparisi
- Hospital General de Valencia, Valencia, Spain
| | | | | | | | - J Saldaña
- Institut Català D'Oncologia-L'Hospitalet, Barcelona, Spain
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Gironés R, Aparisi F, Sánchez A, García J, Juan Ó. P2.01-031 Use of Geriatric Assessment (GA) in Clinical Practice for Stage IV Non-Small Cell Lung Cancer (NSCLC). The GIDO Experience. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Aparicio J, Terrasa J, Durán I, Germà-Lluch JR, Gironés R, González-Billalabeitia E, Gumà J, Maroto P, Pinto A, García-Del-Muro X. SEOM clinical guidelines for the management of germ cell testicular cancer (2016). Clin Transl Oncol 2016; 18:1187-1196. [PMID: 27815687 PMCID: PMC5138244 DOI: 10.1007/s12094-016-1566-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 10/25/2016] [Indexed: 11/28/2022]
Abstract
Testicular cancer represents the most common malignancy in males aged 15–34 years and is considered a model of curable neoplasm. Maintaining success, reducing treatment burden, and focusing on survivorship are then key objectives. Inguinal orchiectomy is the first recommended maneuver that has both diagnostic and therapeutic aims. Most patients are diagnosed with stage I disease (confined to the testicle). Close surveillance and selective, short-course adjuvant chemotherapy are accepted alternatives for these cases. In patients with more advanced disease (stages II and III), 3–4 courses of cisplatin-based chemotherapy (according to IGCCCG risk classification) followed by the judicious surgical removal of residual masses represent the cornerstone of therapy. Poor-risk patients and those failing a first-line therapy should be referred to specialized tertiary centers. Paclitaxel-based conventional chemotherapy and high-dose chemotherapy plus autologous hematopoietic support can cure a proportion of patients with relapsing or refractory disease.
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Affiliation(s)
- J Aparicio
- Servicio de Oncología Médica, Hospital Universitario y Politécnico La Fe, Av. Abril Martorell 106, 46026, Valencia, Spain.
| | - J Terrasa
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Durán
- Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J R Germà-Lluch
- Institut Català d'Oncologia, ICO-IDIBELL L'Hospitalet, Barcelona, Spain
| | - R Gironés
- Hospital Lluis Alcanyis, Xátiva, Spain
| | - E González-Billalabeitia
- Hospital Universitario Morales Meseguer-IMIB, Universidad Católica de Murcia-UCAM, Murcia, Spain
| | - J Gumà
- Hospital Universitario Sant Joan de Reus, URV, IISPV, Reus, Spain
| | - P Maroto
- Hospital de Sant Pau, Barcelona, Spain
| | - A Pinto
- Hospital Universitario La Paz, Madrid, Spain
| | - X García-Del-Muro
- Institut Català d'Oncologia, ICO-IDIBELL L'Hospitalet, Barcelona, Spain
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Gironés R, Alonso J, Arcusa A, Sánchez A, Barretina P, Borrega P, Cueva J, Alarcón J, Esteban M, Fuentes J, Garcia A, Garrigos L, Guerra E, Herrero A, Lainez N, Maximiano C, Martínez P, González-Martín A. 2774 ROSE study: A retrospective evaluation of clinical management of advanced ovarian cancer (AOC) in Spain by the Spanish Group for Research in Ovarian Cancer (GEICO). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Gironés R, Provencio M, Majem M, Garrido P, Felip E, Felip E, Viñolas N, Artal A, Isla L, Carcereny E, García-Campelo C, Lianes P, De las Peñas R. Lung cancer in women: Do tumors behave differently in the elderly? A prospective comparison of World07 data base. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Blasco A, Galan A, Almenar D, Gironés R, Diaz R, Alberola V. Pain, depression, asthenia, and insomnia: Prevalence of this symptoms cluster and its impact on health-related quality of life in a cohort of advanced cancers. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20607 Background: Pain (P), depression (D), asthenia (A), and insomnia (I), alone or in combination, are some of the most important and invalidating cancer symptoms. But little is known about the relationship between the symptoms of this cluster, and its impact on health-related quality of life (HRQoL). This analysis has been carried out to better know the prevalence of this symptoms cluster and its impact on HRQoL in cancer patients (pts). Methods: An observational and longitudinal multicentre study was carried out on a sample of cancer pts with breast, lung or colon cancer, any site and period of disease duration, receiving chemotherapy. Data were collected at inclusion and 3 months later. Sociodemographic data, key clinical indicators, as well as P, D, A and I complaints or diagnosis were collected. HRQoL was assessed by means of Nottingham Health Profile (NHP) scale (a generic health measure. Analyses were focused on baseline cross-sectional data). Results: A total of 116 pts were analyzed: 73.3 men, 61 years old (SD=9,1), 2.9 years (SD=2,3) since diagnosis, 16.4 % breast, 54.3% lung, and 29.3% colon cancer; 97.4% with metastasis. At least one symptom cluster under study was presented in 69% of pts: >25% a symptom alone, ≈25% two symptoms, >15% three symptoms, <3% all symptoms in the cluster. Pts could be classified in 13 of the 15 symptoms cluster possible combinations (according to their symptoms complaints/diagnosis) ranging from 0.9% to 12.9%. The two symptoms cluster combinations which did not obtain representation included D + I, while the two symptoms cluster combinations more frequents always included pain. It has been observed that a more quantity of symptoms worst physical and psychological NHP scores. Conclusions: The prevalence of the studied symptoms cluster in cancer pts is high (≈70%) and divers in combinations (13 different symptoms profiles). The quantity of prevalent symptoms cluster is clearly associated with HRQoL. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- A. Blasco
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - A. Galan
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - D. Almenar
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - R. Gironés
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - R. Diaz
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
| | - V. Alberola
- Hospital General Universitario de Valencia, Valencia, Spain; Hospital General de Sagunto, Sagunto, Spain; Hospital Universitario Dr. Peset, Valencia, Spain; Hospital Lluis Alcanyis, Xativa, Spain; Hospital Universitario La Fe, Valencia, Spain; Hospital Arnau de Vilanova, Valencia, Spain
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Gironés R, Díaz-Beveridge R, Torregrosa D, López P, Gómez-Codina J, Yuste A, Saldaña J, Rosell R. P.16 Social support of elderly lung cancer patients. Crit Rev Oncol Hematol 2007. [DOI: 10.1016/s1040-8428(13)70189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Torregrosa D, Gironés R, López P, Díaz Beveridge R, Maestu I. Reproductive risk factors of breast cancer in elderly population. A single centre study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.21187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
21187 Background: Relationship between reproductive variables and cancer risk has been yet established. Protective effect of late age at menarche (≥ 11) and high parity (≥ 4) and the increased risk of nulliparous women, older age at first birth (AFB) (≥ 28) and older age at menopause (≥ 52) seems to act differently in pre vs. postmenopausal elderly women. The aim of this study was to describe recognized reproductive risk factors for breast cancer in a selected population of a single centre. Methods: A cross- sectional study of women diagnosed ≥ 70 years. We selected women with removed early breast cancer and on follow-up. No disease recurrences were allowed. Between January 2005 to June 2006. Described reproductive risk factors for breast cancer were collected. Tumour characteristics also. Results: 91 patients were recruited. Mean age at time of diagnosis: 76 (70–92); mean age at study 80 (71- 95). Reproductive factors: late age at menarche (12; 9–16; percentile 75: 14) and late age at menopause: 48 (29–56); 75% ≥ 52 years old were common. Nulliparous women were similar at described in other series (10%); parity 2 (0–9); percentile 75: 3;late AFB: 26 (19–40); percentile 75: 29 years. No one had taken hormonal treatment. Only 16% had familiar history of breast cancer and 9% personal history. Almost all (84%) had positive tumours for the oestrogen receptor and 76% for progesterone receptor. 91% had ductal histology and 54% had II stage. Conclusions: Discussion: unexpected associations between classical reproductive risk factors and breast cancer on elderly patients have been described in other series. It seems that late age at menarche and late age at menopause is common in elderly breast cancer population, as in our serie. Nulliparous elderly continue to have risk but seems that the protective effect of parity dissipated in these population. Older age at first birth (≥28) is consistently associated with increased breast cancer risk. Conclusion: our study is based on a high selected population and clearly has a selection bias. Our results cannot be generalized to other populations but describes our patients. The results therefore should be internally valid. And it seems to coincide with other studies. No significant financial relationships to disclose.
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Affiliation(s)
- D. Torregrosa
- Hospital LLuís Alcanyís, Xàtiva, Valencia, Spain; Hospital La FE, Valencia, Spain; Hospital Virgen de Los Lirios, Alcoi, Alicante, Spain
| | - R. Gironés
- Hospital LLuís Alcanyís, Xàtiva, Valencia, Spain; Hospital La FE, Valencia, Spain; Hospital Virgen de Los Lirios, Alcoi, Alicante, Spain
| | - P. López
- Hospital LLuís Alcanyís, Xàtiva, Valencia, Spain; Hospital La FE, Valencia, Spain; Hospital Virgen de Los Lirios, Alcoi, Alicante, Spain
| | - R. Díaz Beveridge
- Hospital LLuís Alcanyís, Xàtiva, Valencia, Spain; Hospital La FE, Valencia, Spain; Hospital Virgen de Los Lirios, Alcoi, Alicante, Spain
| | - I. Maestu
- Hospital LLuís Alcanyís, Xàtiva, Valencia, Spain; Hospital La FE, Valencia, Spain; Hospital Virgen de Los Lirios, Alcoi, Alicante, Spain
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Gironés R, Torregrosa D, Maestu I, Díaz-Beveridge R, Gómez-Codina J, Yuste A, Rosell R. 14 Attitudes toward chemotherapy in elderly patients (pts) with advanced non-small lung cancer. Preliminary results of a single-centre study. Crit Rev Oncol Hematol 2006. [DOI: 10.1016/s1040-8428(13)70085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gironés R, Torregrosa D, Maestu I, Díaz-Beveridge R, Gómez-Codina J, Yuste A, Rosell R. 13 Elderly patients with NSCLC: what do they know? Do they want to know? Preliminary results of a single centre experience. Crit Rev Oncol Hematol 2006. [DOI: 10.1016/s1040-8428(13)70084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Segura A, Yuste A, Cercos A, López-Tendero P, Gironés R, Pérez-Fidalgo JA, Herranz C. Pulmonary fibrosis induced by cyclophosphamide. Ann Pharmacother 2001; 35:894-7. [PMID: 11485142 DOI: 10.1345/aph.10297] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To report a case of pulmonary fibrosis resulting from use of cyclophosphamide as chemotherapy to treat a patient with breast cancer. CASE SUMMARY We describe the case of a 52-year-old woman with breast cancer who developed pulmonary fibrosis after four cycles of chemotherapy that included cyclophosphamide. Pulmonary function tests revealed the presence of a severe ventilatory restriction. The open lung biopsy revealed pulmonary fibrosis with vascular sclerosis and signs of pulmonary hypertension. DISCUSSION Cyclophosphamide is an alkylating agent that has been associated with interstitial pneumonia and pulmonary fibrosis. The frequency of these unwanted effects is <1%. The clinical picture consists of the progressive appearance of dyspnea and a non-productive cough that progresses to severe pulmonary insufficiency. The risk factors described for these complications have been the use of chemotherapy regimens that include other drugs with known pulmonary toxicities, the cumulative total dose, the addition of radiotherapy, and the use of high doses of cyclophosphamide. CONCLUSIONS Even though the frequency of pulmonary fibrosis in patients treated with cyclophosphamide-based chemotherapy regimens is low, the presence of dyspnea and an interstitial pattern in a patient makes it necessary to consider that possible drug toxicity. The open lung biopsy is the most accurate diagnostic technique for these cases. The discontinuation of cyclophosphamide and treatment with corticosteroids is usually followed by clinical recovery in approximately 50% of patients and, in some cases, reversal of the lung injury.
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Affiliation(s)
- A Segura
- Medical Oncology Department, University Hospital La Fe, Valencia, Spain.
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Ballester MJ, Gironés R, Torres JV, Guillén P, Osborne NG, Bonilla-Musoles F. Diagnosis of endometrial carcinoma: predictive value of transvaginal color Doppler. J Gynecol Surg 1995; 10:173-83. [PMID: 10150394 DOI: 10.1089/gyn.1994.10.173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of this study was to determine whether transvaginal ultrasound plus color Doppler flow improve the ability to diagnose endometrial carcinoma and allow better discrimination between benign and malignant endometrial lesions. One hundred thirty women with abnormal uterine bleeding were evaluated with transvaginal color Doppler before fractional dilatation and curettage (D&C). The endometrial line thickness and endometrial characteristics were evaluated by endosonography. The resistive and pulsatile indices of the uterine arteries and of the endometrium were evaluated with transvaginal color Doppler. Following D&C and tissue diagnosis, women were divided into two groups, 62 with a histologic diagnosis of endometrial adenocarcinoma and 68 with benign endometrial tissue. All women with endometrial carcinoma underwent TAH and BSO. A complete histopathologic study was done an all surgical specimens. The International Federation of Gynecology and Obstetrics (FIGO) stage and tissue grading were determined in all cases. The histopathologic findings were correlated with ultrasound and transvaginal color Doppler results. Patients with adenocarcinoma had an average endometrial thickness of 26.13 mm (range 8-87 mm). The average thickness for functional endometrium (proliferative) was 10.5 mm (range 6-23 mm). There was no case of carcinoma where the endometrial thickness was less than 8 mm. Intraendometrial neovascularization was not observed in any case with functional or atrophic endometrium. The flow indices in patients with endometrial adenocarcinomas are significantly different from the flow indices of patients with benign endometrial tissue. Transvaginal color Doppler increases the sensitivity of endometrial malignancy diagnosis. The method is capable of detecting important differences in flow indices and endometrial line characteristics between benign and malignant endometrial tissue.
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Affiliation(s)
- M J Ballester
- Department of Obstetrics and Gynecology, Facultad de Medicina, Universidad de Valencia, Spain
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Gironés R. [Mediastinoscopy and primary bronchial carcinoma]. Bronches 1965; 15:473-85. [PMID: 5879896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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